Brain morphometry of individuals with schizophrenia with and without antipsychotic medication – The Northern Finland Birth Cohort 1966 Study

Moilanen, Jani; Huhtaniska, Sanna; Haapea, Marianne; Jääskeläinen, Erika; Veijola, Juha; Isohanni, Matti; Koponen, Hannu

doi:10.1016/j.eurpsy.2015.02.009

Cited by 8 publications

(10 citation statements)

References 43 publications

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“…Higher dose-years of antipsychotics associated with decline in verbal learning and memory between ages 34 and 43 years (Husa et al, 2014). High lifetime dose and antipsychotic polypharmacy associated also with poorer outcomes in schizophrenia at the age of 43 years (Moilanen et al, 2015). These results are consistent with the possibility that long-term antipsychotic medication has some adverse effects on the brain, although it remains possible that residual confounding may be responsible for these associations.…”

Section: Antipsychotic Use and Brain Volume Changesupporting

confidence: 58%

“…Benzodiazepines included ATC classes N05BA (anxiolytics, benzodiazepine derivatives), N05CD (hypnotics and sedatives, benzodiazepine derivatives), and N05CF (hypnotics and sedatives, benzodiazepine-related drugs). For antipsychotic medication, the information was used to calculate the cumulative doses of lifetime and interscan interval antipsychotic doses expressed as dose-years of a daily dose of 100 mg chlorpromazine (CPZy) using several sources, see Moilanen et al (2015) for details. For benzodiazepines, the information was used to calculate the defined daily doses (DDD) (Nykänen et al, 2016;Rissanen et al, 2015) and these were then expressed as benzodiazepine dose-years (BZDy).…”

Section: Data On Medicationmentioning

confidence: 99%

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Long-term antipsychotic and benzodiazepine use and brain volume changes in schizophrenia: The Northern Finland Birth Cohort 1966 study

Huhtaniska

Jääskeläinen

Heikka

et al. 2017

Psychiatry Research: Neuroimaging

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High doses of antipsychotics have been associated with loss in cortical and total gray matter in schizophrenia. However, previous imaging studies have not taken benzodiazepine use into account, in spite of evidence suggesting adverse effects such as cognitive impairment and increased mortality. In this Northern Finland Birth Cohort 1966 study, 69 controls and 38 individuals with schizophrenia underwent brain MRI at the ages of 34 and 43 years. At baseline, the average illness duration was over 10 years. Brain structures were delineated using an automated volumetry system, volBrain, and medication data on cumulative antipsychotic and benzodiazepine doses were collected using medical records and interviews. We used linear regression with intracranial volume and sex as covariates; illness severity was also taken into account. Though both medication doses associated to volumetric changes in subcortical structures, after adjusting for each other and the average PANSS total score, higher scan-interval antipsychotic dose associated only to volume increase in lateral ventricles and higher benzodiazepine dose associated with volume decrease in the caudate nucleus. To our knowledge, there are no previous studies reporting associations between benzodiazepine dose and brain structural changes. Further studies should focus on how these observations correspond to cognition and functioning.

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Section: Antipsychotic Use and Brain Volume Changesupporting

confidence: 58%

Section: Data On Medicationmentioning

confidence: 99%

Long-term antipsychotic and benzodiazepine use and brain volume changes in schizophrenia: The Northern Finland Birth Cohort 1966 study

Huhtaniska

Jääskeläinen

Heikka

et al. 2017

Psychiatry Research: Neuroimaging

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“…The notifications in the medical records concerning the use of medication, such as whether a subject had hidden drugs or reported not using them, were taken into account while gathering data on medications. See the Supplementary [27,34], was calculated as chlorpromazine equivalent (mg) multiplied by the time on dose (years).…”

Section: Data On Medicationmentioning

confidence: 99%

“…The data on antipsychotic medication has been used in earlier studies with shorter periods of follow-up[27,31,32].…”

mentioning

confidence: 99%

Long-term antipsychotic use and its association with outcomes in schizophrenia – the Northern Finland Birth Cohort 1966

et al. 2016

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In our population-based sample, the use of antipsychotics increased during the first five years of illness and was relatively stable after that. Our results suggest that both low dose and proportion of use, and having no drug-free periods, are associated with better outcomes, which concords with current treatment recommendations and algorithms. High long-term doses and polypharmacy may relate to poor outcomes.

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“…Information on lifetime use of psychiatric medications, until the day the person was examined in the 43-year study, was gathered by a careful review of individual hospital, outpatient and health centre notes of all cases from everywhere in Finland. This procedure is described in more detail in previous publications from the NFBC1966 (Husa et al, 2014;Moilanen et al, 2015). Current and earlier use of psychiatric medications and their doses were ascertained in the interview at 43year study by asking about the use of psychiatric medications during the previous 3 months and as far as the subjects could remember.…”

Section: Data On Use Of Psychiatric Medicationmentioning

confidence: 99%

Antipsychotic and benzodiazepine use and brain morphology in schizophrenia and affective psychoses – Systematic reviews and birth cohort study

Huhtaniska

Korkala

Heikka

et al. 2018

Psychiatry Research: Neuroimaging

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The aim of this paper was to investigate differences in brain structure volumes between schizophrenia and affective psychoses, and whether cumulative lifetime antipsychotic or benzodiazepine doses relate to brain morphology in these groups. We conducted two systematic reviews on the topic and investigated 44 schizophrenia cases and 19 with affective psychoses from the Northern Finland Birth Cohort 1966. The association between lifetime antipsychotic and benzodiazepine dose and brain MRI scans at the age of 43 was investigated using linear regression. Intracranial volume, sex, illness severity, and antipsychotic/benzodiazepine doses were used as covariates. There were no differences between the groups in brain structure volumes. In schizophrenia, after adjusting for benzodiazepine dose and symptoms, a negative association between lifetime antipsychotic dose and the nucleus accumbens volume remained. In affective psychoses, higher lifetime benzodiazepine dose associated with larger volumes of total gray matter and hippocampal volume after controlling for antipsychotic use and symptoms. It seems that in addition to antipsychotics, the severity of symptoms and benzodiazepine dose are also associated with brain structure volumes. These results suggest, that benzodiazepine effects should also be investigated also independently and not only as a confounder.

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Brain morphometry of individuals with schizophrenia with and without antipsychotic medication – The Northern Finland Birth Cohort 1966 Study

Cited by 8 publications

References 43 publications

Long-term antipsychotic and benzodiazepine use and brain volume changes in schizophrenia: The Northern Finland Birth Cohort 1966 study

Long-term antipsychotic and benzodiazepine use and brain volume changes in schizophrenia: The Northern Finland Birth Cohort 1966 study

Long-term antipsychotic use and its association with outcomes in schizophrenia – the Northern Finland Birth Cohort 1966

Antipsychotic and benzodiazepine use and brain morphology in schizophrenia and affective psychoses – Systematic reviews and birth cohort study

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